Spinal Injections & Nerve Blocks in Delhi

Spinal injections deliver medication precisely to the structure thought to be generating your pain — a nerve root, the epidural space, or a facet joint — under live X-ray guidance.

They are widely offered and widely misunderstood. This page sets out what they can realistically do, and what they cannot, because that gap is where most disappointment comes from.

As a diagnostic test. If your MRI shows changes at three levels, the scan cannot tell us which one is actually causing your leg pain. Anaesthetising one nerve root and seeing whether the pain temporarily disappears can. This is genuinely valuable information, and it is often the single thing that decides whether an operation is worth doing and where.

One honest limitation: a nerve root block is good at telling us when a nerve is not the source, and less reliable in the other direction. Sensitivity is high, around 93%, but specificity is only somewhere between 25% and 50% — which in plain terms means a positive result on its own proves less than you might expect. We read it alongside everything else rather than treating it as a verdict.

As a treatment. An injection can settle inflammation around an irritated nerve and give a window of relief, which for many patients is exactly what is needed to get physiotherapy started or to get through a bad period.

We would rather tell you this than have you discover it afterwards.

Across pooled trials, the average benefit of an epidural steroid injection over a placebo injection for sciatica is around 5 points on a 100-point pain scale in the short term. That is below the difference most patients can reliably detect. Some individuals do far better than the average; others notice nothing.

Epidural injections also do not reduce the likelihood of eventually needing surgery. They change how you feel for a period; they do not change the underlying structural problem.

For axial back pain — pain in the back itself rather than radiating into the leg — and for the walking limitation of central spinal stenosis, guidance is clear that epidural steroid injection should not be used.

None of this means injections are useless. It means they are a tool with a specific job, best used deliberately — to answer a question, or to open a window for rehabilitation — rather than repeated indefinitely in the hope of a cure. If you have had several injections with no lasting benefit, more of them is unlikely to be the answer.

Medication placed precisely where a single nerve root exits the spine. The most targeted option, and the most useful diagnostically. Used for sciatica from a disc herniation or from narrowing around the nerve root.

Medication placed into the epidural space, affecting a broader area rather than one nerve. Used where irritation is more diffuse.

The facet joints are the small paired joints at the back of the spine, and they are a genuine and often overlooked source of back pain. A medial branch block anaesthetises the small nerves carrying sensation from a specific joint. Its main purpose is diagnostic: if blocking those nerves relieves your pain, the joint is confirmed as the source and radiofrequency ablation becomes an option.

Where a diagnostic block has confirmed a facet joint as the source, radiofrequency energy is used to interrupt the small nerves carrying pain from that joint. Relief, when it comes, typically lasts several months to a couple of years, after which the nerves regenerate and the procedure can be repeated.

We should say that the evidence for facet joint ablation is contested rather than settled — a large trial was negative, though it was heavily criticised on how patients were selected. The consistent finding across the literature is that careful diagnostic blocks beforehand are what separates the patients who benefit from those who do not. We will not offer ablation without that step.

Every injection on this page is performed under live X-ray guidance, with contrast used to confirm that the medication is going exactly where it is meant to go before any is given.

Injections given blind, by feel alone, miss their target often enough to matter — which means a patient can be told an injection failed when in truth it was never delivered to the right place, and a genuinely useful diagnostic result is lost. For transforaminal injections in particular, guidance and the correct choice of medication are safety issues, not refinements.

If you are offered a spinal injection anywhere without imaging guidance, it is reasonable to ask why.

• Day-care. You come in, have the procedure, and go home the same day.
• Anaesthetic. Local, sometimes with light sedation. You stay awake, which matters — we may ask what you feel during the procedure.
• Duration. Usually 15 to 30 minutes.
• Afterwards. A short period of observation. You will need someone to take you home.
• Timing of relief. Local anaesthetic can relieve pain within minutes but wears off within hours — that early window is the diagnostic information. Steroid effect, if any, builds over several days.
• Keeping a record. We will ask you to note how much relief you had and for how long. This is not a formality; it is the data that determines what we do next.

Risks are low but real: bleeding, infection, a temporary increase in pain, a headache if the dural membrane is punctured, a short-lived rise in blood sugar after steroid which matters if you are diabetic, and rarely nerve injury.

Will a spinal injection cure my sciatica?

No, and we would not present it that way. An injection can reduce inflammation around an irritated nerve and give a window of relief, but it does not change the underlying disc problem. Across pooled trials the average benefit over a placebo injection is around 5 points on a 100-point scale in the short term, and epidural injections do not reduce the likelihood of eventually needing surgery. They are most useful for confirming which nerve is responsible, or for making rehabilitation possible.

How long does a spinal injection last?

It varies widely. Local anaesthetic gives relief within minutes that wears off within hours — that early window is the diagnostic information we want. Any steroid effect builds over several days and may last weeks to a few months, or may not happen at all. Radiofrequency ablation, where a diagnostic block has confirmed a facet joint as the source, typically gives several months to a couple of years before the nerves regenerate.

Are spinal injections painful?

They are done under local anaesthetic, sometimes with light sedation, and most patients describe pressure rather than sharp pain. You stay awake deliberately, because what you feel during the procedure can tell us which structure is involved. Some patients have a temporary increase in pain for a day or two afterwards before any benefit appears.

How many injections can I have?

There is no fixed number, but the more useful question is whether they are working. If you have had several injections with no lasting benefit, repeating them is unlikely to change that, and it is better to reconsider the diagnosis or discuss other options. Repeated steroid injections also carry cumulative considerations, particularly for bone density and blood sugar control.

Why does the injection need to be done under X-ray?

Because accuracy determines both safety and usefulness. Contrast is used to confirm the medication is going exactly where intended before any is given. An injection placed blind may miss its target, which means you can be told it failed when it was simply never delivered to the right place — and the diagnostic information is lost. For transforaminal injections, guidance and the correct choice of medication are safety matters.

Spinal injections and nerve blocks are performed by Dr. Om Prakash Gupta, Senior Consultant Orthopaedic & Endoscopic Spine Surgeon, as part of Sama’s Minimally Invasive & Endoscopic Spine Surgery service.

Sama Hospital, 8 Siri Fort Road, Sadiq Nagar, New Delhi 110049. 24/7 emergency; specialist OPD during daytime hours. For an estimate of cost, call us — please bring your MRI films.